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Individual

KENNETH DARRYL KAWA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
21230 DEQUINDRE RD, WARREN, MI 48091-2279
(586) 427-1000
Mailing address
21230 DEQUINDRE RD, WARREN, MI 48091-2279
(586) 427-1000

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704127316
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2749009
MI
01
430F364420
BCBSM
MI
Enumeration date
03/10/2006
Last updated
11/11/2009
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